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Austin, Texas

Claim Specialist


Next Insurance is a fast-growing 300 person startup based in Silicon Valley and is led by a team of experienced entrepreneurs with a history of successful outcomes. Our mission is to transform insurance for small businesses by combining world-class technology and phenomenal customer service to offer better insurance at a lower price. Next has raised over $380 million from top tier investors and is the valley’s latest unicorn, valued at over $1 billion.

 

Next is well-positioned to become the leader in the $140 billion small business insurance market because we offer a 100% online experience that is tailored to unique business needs and we get customers insured in minutes – something no one else does. Despite the size of the market, the experience of buying small business insurance has not caught up with best practices instituted in other industries like banking, lending, and even personal lines insurance. There is still a lot of paper involved, purchasing a policy can take days or even weeks, and the coverage is so complex that it’s hard for entrepreneurs to understand what they are buying. We’re here to change that. Our goal is to make insurance simple, affordable, and transparent for small businesses so they can stop worrying about insurance and focus on running their businesses.

 

 

This key role will be deemed a subject matter expert in the claim department. Your extensive experience in commercial claims will allow you to handle high severity and high complexity claims. You will assist in department roundtables and provide guidance to the department.

Responsibilities:

Extensive knowledge of policy documents and legal contract interpretation.

Working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management.

Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management.

Litigation handling experience in both General Liability and Casualty files.

Proven ability to drive litigation, attend mediations, trials, and other alternative dispute resolution avenues.

Communicates with policyholders, witnesses, and claimants, in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to the proper course of action.

Responds to various written and telephone inquiries including status reports.

Present file materials for authority and roundtables.

Work with nurses, doctors, and attorneys on file reviews.

Comply with all statutory and regulatory requirements of all applicable jurisdiction.

Meet detailed quality assurance standards and meet set goals of performance.

Set and revise case reserves in accordance with the reserving policy.

Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.

Accountable for security of financial processing of claims, as well as security information contained in claims files.

Work with and provide claim-specific guidance to Independent Field Adjuster.

Partner closely with internal teams and advise the leadership of key claim activities and exposures.

Desired Skills and Experience:

The capabilities, skills, and knowledge required is normally acquired through a Bachelors degree or equivalent experience and at least 13+ years of directly related experience.

Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills.

In-depth knowledge of multi-jurisdictional claims handling issues

Candidates must have, or be able to promptly obtain a Texas Independent Adjuster License

Effective communication, presentation, negotiation, and persuasion skills.

Ability to collaborate with cross-functional teams to achieve business results.

Proven success delivering in rapidly changing claims environment.

Achieves a standard of excellence with work processes and outcomes, honoring company policies and regulatory compliance.

Team oriented, building strong working relationships and a positive work environment.

Is receptive to feedback and willing to learn, embracing continuous improvement.

Travel capability, up to 10% of work time, is required.

BS / BA Degree preferred

Advanced studies or insurance designation preferred